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1. Outcomes with General Anesthesia Compared to Conscious Sedation for Endovascular Treatment of Medium Vessel Occlusions: Results of an International Multicentric Study

Author

Radu, Răzvan Alexandru, Costalat, Vincent, Romoli, Michele, Musmar, Basel, Siegler, James E., Ghozy, Sherief, Khalife, Jane, Salim, Hamza, Shaikh, Hamza, Adeeb, Nimer, Cuellar-Saenz, Hugo H., Thomas, Ajith J., Kadirvel, Ramanathan, Abdalkader, Mohamad, Klein, Piers, Nguyen, Thanh N., Heit, Jeremy J., Regenhardt, Robert W., Bernstock, Joshua D., Patel, Aman B., Rabinov, James D., Stapleton, Christopher J., Cancelliere, Nicole M., Marotta, Thomas R., Mendes Pereira, Vitor, El Naamani, Kareem, Amllay, Abdelaziz, Tjoumakaris, Stavropoula I., Jabbour, Pascal, Meyer, Lukas, Fiehler, Jens, Faizy, Tobias D., Guerreiro, Helena, Dusart, Anne, Bellante, Flavio, Forestier, Géraud, Rouchaud, Aymeric, Mounayer, Charbel, Kühn, Anna Luisa, Puri, Ajit S., Dyzmann, Christian, Kan, Peter T., Colasurdo, Marco, Marnat, Gaultier, Berge, Jérôme, Barreau, Xavier, Sibon, Igor, Nedelcu, Simona, Henninger, Nils, Ota, Takahiro, Dofuku, Shogo, Yeo, Leonard L. L., Tan, Benjamin YQ, Gopinathan, Anil, Martinez-Gutierrez, Juan Carlos, Salazar-Marioni, Sergio, Sheth, Sunil, Renieri, Leonardo, Capirossi, Carolina, Mowla, Ashkan, Chervak, Lina M., Vagal, Achala, Khandelwal, Priyank, Biswas, Arundhati, Clarençon, Frédéric, Elhorany, Mahmoud, Premat, Kevin, Valente, Iacopo, Pedicelli, Alessandro, Alexandre, Andrea M., Filipe, João Pedro, Varela, Ricardo, Quintero-Consuegra, Miguel, Gonzalez, Nestor R., YMD, Markus A., Jesser, Jessica, Weyland, Charlotte, ter Schiphorst, Adrien, Yedavalli, Vivek, Harker, Pablo, Aziz, Yasmin, Gory, Benjamin, Paul Stracke, Christian, Hecker, Constantin, Killer-Oberpfalzer, Monika, Griessenauer, Christoph J., Hsieh, Cheng-Yang, Liebeskind, David S., Tancredi, Illario, Fahed, Robert, Lubicz, Boris, Essibayi, Muhammed Amir, Baker, Amanda, Altschul, David, Scarcia, Luca, Kalsoum, Erwah, Dmytriw, Adam A., and Guenego, Adrien

Published
2024
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8. Prevalence and incidence of cognitive impairment and dementia in heart failure – A systematic review, meta-analysis and meta-regression

Author

Yap, Nicole Li Xian, Kor, Qianyi, Teo, Yao Neng, Teo, Yao Hao, Syn, Nicholas L., Evangelista, Lauren Kay Mance, Tan, Benjamin YQ., Lin, Weiqin, Yeo, Leonard LL., Kong, William KF., Chong, Yao Feng, Wong, Raymond CC., Poh, Kian Keong, Yeo, Tiong-Cheng, Sharma, Vijay Kumar, Chai, Ping, Chan, Mark Y., Goh, Fang Qin, and Sia, Ching-Hui

Published
2022
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9. Outcomes of mechanical thrombectomy in anticoagulated patients with acute distal and medium vessel stroke.

Author

Salim, Hamza, Musmar, Basel, Adeeb, Nimer, Yedavalli, Vivek, Lakhani, Dhairya, Grewal, Sahibjot Singh, El Naamani, Kareem, Henninger, Nils, Sundararajan, Sri Hari, Kühn, Anna Luisa, Khalife, Jane, Ghozy, Sherief, Scarcia, Luca, Tan, Benjamin YQ, Regenhardt, Robert W, Heit, Jeremy J, Cancelliere, Nicole M, Bernstock, Joshua D, Rouchaud, Aymeric, and Fiehler, Jens

Published
2024
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10. Pretreatment predictors of very poor clinical outcomes in medium vessel occlusion stroke patients treated with mechanical thrombectomy.

Author

Yedavalli, Vivek, Salim, Hamza, Musmar, Basel, Adeeb, Nimer, El Naamani, Kareem, Henninger, Nils, Sundararajan, Sri Hari, Kühn, Anna Luisa, Khalife, Jane, Ghozy, Sherief, Scarcia, Luca, Tan, Benjamin YQ, Heit, Jeremy J, Regenhardt, Robert W, Cancelliere, Nicole M, Bernstock, Joshua D, Rouchaud, Aymeric, Fiehler, Jens, Sheth, Sunil, and Essibayi, Muhammed Amir

Subjects
ISCHEMIC stroke, TISSUE plasminogen activator, CEREBRAL infarction, ENDOVASCULAR surgery, PATIENT selection
Abstract

Background: Acute ischemic stroke (AIS) from primary medium vessel occlusions (MeVO) is a prevalent condition associated with substantial morbidity and mortality. Despite the common use of mechanical thrombectomy (MT) in AIS, predictors of poor outcomes in MeVO remain poorly characterized. Methods: In this prospectively collected, retrospectively reviewed, multicenter, multinational study, data from the MAD-MT (Multicenter Analysis of primary Distal medium vessel occlusions: effect of Mechanical Thrombectomy) registry were analyzed. The study included 1568 patients from 37 academic centers across North America, Asia, and Europe, treated with MT, with or without intravenous tissue plasminogen activator (IVtPA), between September 2017 and July 2021. Results: Among the 1568 patients, 347 (22.2%) experienced very poor outcomes (modified Rankin score (mRS), 5–6). Key predictors of poor outcomes were advanced age (odds ratio (OR): 1.03; 95% confidence interval (CI): 1.02 to 1.04; p < 0.001), higher baseline National Institutes of Health Stroke Scale (NIHSS) scores (OR: 1.07; 95% CI: 1.05 to 1.10; p < 0.001), pre-operative glucose levels (OR: 1.01; 95% CI: 1.00 to 1.02; p < 0.001), and a baseline mRS of 4 (OR: 2.69; 95% CI: 1.25 to 5.82; p = 0.011). The multivariable model demonstrated good predictive accuracy with an area under the receiver-operating characteristic (ROC) curve of 0.76. Conclusions: This study demonstrates that advanced age, higher NIHSS scores, elevated pre-stroke mRS, and pre-operative glucose levels significantly predict very poor outcomes in AIS-MeVO patients who received MT. These findings highlight the importance of a comprehensive risk assessment in primary MeVO patients for personalized treatment strategies. However, they also suggest a need for cautious patient selection for endovascular thrombectomy. Further prospective studies are needed to confirm these findings and explore targeted therapeutic interventions. [ABSTRACT FROM AUTHOR]

Published
2024
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15. Endovascular Therapy vs. Best Medical Management in Distal Medium Middle Cerebral Artery Acute Ischemic Stroke: A Multinational Multicenter Propensity Score-Matched Study

Author

Salim, Hamza A., primary, Yedavalli, Vivek, additional, Musmar, Basel, additional, Adeeb, Nimer, additional, Naamani, Kareem El, additional, Henninger, Nils, additional, Sundararajan, Sri Hari, additional, Kuhn, Anna Luisa, additional, Khalife, Jane, additional, Ghozy, Sherief, additional, Scarcia, Luca, additional, Tan, Benjamin YQ, additional, Heit, Jeremy J., additional, Regenhardt, Robert, additional, Cancelliere, Nicole M., additional, Bernstock, Joshua D., additional, Rouchaud, Aymeric, additional, Fiehler, Jens, additional, Sheth, Sunil A., additional, Essibayi, Muhammed Amir, additional, Puri, Ajit S., additional, Dyzmann, Christian, additional, Colasurdo, Marco, additional, Barreau, Xavier, additional, Renieri, Leonardo, additional, Filipe, João Pedro, additional, Harker, Pablo, additional, Radu, Răzvan Alexandru, additional, Marotta, Thomas R., additional, Spears, Julian, additional, Ota, Takahiro, additional, Mowla, Ashkan, additional, Jabbour, Pascal M., additional, Biswas, Arundhati, additional, Clarençon, Frédéric, additional, Siegler, James E., additional, Nguyen, Thanh N., additional, Varela, Ricardo, additional, Baker, Amanda, additional, Altschul, David, additional, Gonzalez, Nestor R., additional, Mohlenbruch, Markus, additional, Costalat, Vincent, additional, Gory, Benjamin, additional, Stracke, Christian Paul, additional, Aziz-Sultan, Ali, additional, Hecker, Constantin, additional, Shaikh, Hamza, additional, Liebeskind, David S., additional, Pedicelli, Alessandro, additional, Alexandre, Andrea M., additional, Tancredi, Illario, additional, Faizy, Tobias D., additional, Kalsoum, Erwah, additional, Lubicz, Boris, additional, Patel, Aman B., additional, Pereira, Vitor Mendes, additional, Guenego, Adrien, additional, and Dmytriw, Adam A., additional

Published
2024
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16. Machine Learning Modeling to Predict Atrial Fibrillation Detection in Embolic Stroke of Undetermined Source Patients.

Author

Ming, Chua, Lee, Geraldine J. W., Teo, Yao Hao, Teo, Yao Neng, Toh, Emma M. S., Li, Tony Y. W., Guo, Chloe Yitian, Ding, Jiayan, Zhou, Xinyan, Teoh, Hock Luen, Seow, Swee-Chong, Yeo, Leonard L. L., Sia, Ching-Hui, Lip, Gregory Y. H., Motani, Mehul, and Tan, Benjamin YQ

Subjects
MACHINE learning, ATRIAL fibrillation, STROKE, RECEIVER operating characteristic curves, ISCHEMIC stroke
Abstract

Background: In patients with embolic stroke of undetermined source (ESUS), occult atrial fibrillation (AF) has been implicated as a key source of cardioembolism. However, only a minority acquire implantable cardiac loop recorders (ILRs) to detect occult paroxysmal AF, partly due to financial cost and procedural inconvenience. Without the initiation of appropriate anticoagulation, these patients are at risk of increased ischemic stroke recurrence. Hence, cost-effective and accurate methods of predicting AF in ESUS patients are highly sought after. Objective: We aimed to incorporate clinical and echocardiography data into machine learning (ML) algorithms for AF prediction on ILRs in ESUS. Methods: This was a single-center cohort study that included 157 consecutive patients diagnosed with ESUS from October 2014 to October 2017 who had ILR evaluation. We developed four ML models, with hyperparameters tuned, to predict AF detection on an ILR. Results: The median age of the cohort was 67 (IQR 59–74) years old and the median monitoring duration was 1051 (IQR 478–1287) days. Of the 157 patients, 32 (20.4%) had occult AF detected on the ILR. Support vector machine predicted for AF with a 95% confidence interval area under the receiver operating characteristic curve (AUC) of 0.736–0.737, multilayer perceptron with an AUC of 0.697–0.708, XGBoost with an AUC of 0.697–0.697, and random forest with an AUC of 0.663–0.674. ML feature importance found that age, HDL-C, and admitting heart rate were important non-echocardiography variables, while peak mitral A-wave velocity and left atrial volume were important echocardiography parameters aiding this prediction. Conclusion: Machine learning modeling incorporating clinical and echocardiographic variables predicted AF in ESUS patients with moderate accuracy. [ABSTRACT FROM AUTHOR]

Published
2024
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17. First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: An analysis of an international multicenter study

Author

Radu, Răzvan Alexandru, primary, Costalat, Vincent, additional, Fahed, Robert, additional, Ghozy, Sherief, additional, Siegler, James E, additional, Shaikh, Hamza, additional, Khalife, Jane, additional, Abdalkader, Mohamad, additional, Klein, Piers, additional, Nguyen, Thanh N, additional, Heit, Jeremy J, additional, Sweid, Ahmad, additional, El Naamani, Kareem, additional, Regenhardt, Robert W, additional, Diestro, Jose Danilo Bengzon, additional, Cancelliere, Nicole M, additional, Amllay, Abdelaziz, additional, Meyer, Lukas, additional, Dusart, Anne, additional, Bellante, Flavio, additional, Forestier, Géraud, additional, Rouchaud, Aymeric, additional, Saleme, Suzana, additional, Mounayer, Charbel, additional, Fiehler, Jens, additional, Kühn, Anna Luisa, additional, Puri, Ajit S, additional, Dyzmann, Christian, additional, Kan, Peter T, additional, Colasurdo, Marco, additional, Marnat, Gaultier, additional, Berge, Jérôme, additional, Barreau, Xavier, additional, Sibon, Igor, additional, Nedelcu, Simona, additional, Henninger, Nils, additional, Kyheng, Maéva, additional, Marotta, Thomas R, additional, Stapleton, Christopher J, additional, Rabinov, James D, additional, Ota, Takahiro, additional, Dofuku, Shogo, additional, Yeo, Leonard LL, additional, Tan, Benjamin YQ, additional, Martinez-Gutierrez, Juan Carlos, additional, Salazar-Marioni, Sergio, additional, Sheth, Sunil, additional, Renieri, Leonardo, additional, Capirossi, Carolina, additional, Mowla, Ashkan, additional, Tjoumakaris, Stavropoula I, additional, Jabbour, Pascal, additional, Khandelwal, Priyank, additional, Biswas, Arundhati, additional, Clarençon, Frédéric, additional, Elhorany, Mahmoud, additional, Premat, Kevin, additional, Valente, Iacopo, additional, Pedicelli, Alessandro, additional, Pedro Filipe, João, additional, Varela, Ricardo, additional, Quintero-Consuegra, Miguel, additional, Gonzalez, Nestor R, additional, Möhlenbruch, Markus A, additional, Jesser, Jessica, additional, Tancredi, Illario, additional, ter Schiphorst, Adrien, additional, Yedavalli, Vivek, additional, Harker, Pablo, additional, Chervak, Lina M, additional, Aziz, Yasmin, additional, Gory, Benjamin, additional, Paul Stracke, Christian, additional, Hecker, Constantin, additional, Killer-Oberpfalzer, Monika, additional, Griessenauer, Christoph J, additional, Thomas, Ajith J, additional, Hsieh, Cheng-Yang, additional, Liebeskind, David S, additional, Alexandre, Andrea M, additional, Faizy, Tobias D, additional, Weyland, Charlotte, additional, Patel, Aman B, additional, Pereira, Vitor Mendes, additional, Lubicz, Boris, additional, Dmytriw, Adam A, additional, and Guenego, Adrien, additional

Published
2023
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19. First pass effect as an independent predictor of functional outcomes in medium vessel occlusions: An analysis of an international multicenter study

Author

Radu, Răzvan Alexandru, Costalat, Vincent, Fahed, Robert, Ghozy, Sherief, Siegler, James E, Shaikh, Hamza, Khalife, Jane, Abdalkader, Mohamad, Klein, Piers, Nguyen, Thanh N, Heit, Jeremy J, Sweid, Ahmad, El Naamani, Kareem, Regenhardt, Robert W, Diestro, Jose Danilo Bengzon, Cancelliere, Nicole M, Amllay, Abdelaziz, Meyer, Lukas, Dusart, Anne, Bellante, Flavio, Forestier, Géraud, Rouchaud, Aymeric, Saleme, Suzana, Mounayer, Charbel, Fiehler, Jens, Kühn, Anna Luisa, Puri, Ajit S, Dyzmann, Christian, Kan, Peter T, Colasurdo, Marco, Marnat, Gaultier, Berge, Jérôme, Barreau, Xavier, Sibon, Igor, Nedelcu, Simona, Henninger, Nils, Kyheng, Maéva, Marotta, Thomas R, Stapleton, Christopher J, Rabinov, James D, Ota, Takahiro, Dofuku, Shogo, Yeo, Leonard LL, Tan, Benjamin YQ, Martinez-Gutierrez, Juan Carlos, Salazar-Marioni, Sergio, Sheth, Sunil, Renieri, Leonardo, Capirossi, Carolina, Mowla, Ashkan, Tjoumakaris, Stavropoula I, Jabbour, Pascal, Khandelwal, Priyank, Biswas, Arundhati, Clarençon, Frédéric, Elhorany, Mahmoud, Premat, Kevin, Valente, Iacopo, Pedicelli, Alessandro, Pedro Filipe, João, Varela, Ricardo, Quintero-Consuegra, Miguel, Gonzalez, Nestor R, Möhlenbruch, Markus A, Jesser, Jessica, Tancredi, Illario, ter Schiphorst, Adrien, Yedavalli, Vivek, Harker, Pablo, Chervak, Lina M, Aziz, Yasmin, Gory, Benjamin, Paul Stracke, Christian, Hecker, Constantin, Killer-Oberpfalzer, Monika, Griessenauer, Christoph J, Thomas, Ajith J, Hsieh, Cheng-Yang, Liebeskind, David S, Alexandre, Andrea M, Faizy, Tobias D, Weyland, Charlotte, Patel, Aman B, Pereira, Vitor Mendes, Lubicz, Boris, Dmytriw, Adam A, and Guenego, Adrien

Abstract

Introduction: First pass effect (FPE), achievement of complete recanalization (mTICI 2c/3) with a single pass, is a significant predictor of favorable outcomes for endovascular treatment (EVT) in large vessel occlusion stroke (LVO). However, data concerning the impact on functional outcomes and predictors of FPE in medium vessel occlusions (MeVO) are scarce.Patients and Methods: We conducted an international retrospective study on MeVO cases. Multivariable logistic modeling was used to establish independent predictors of FPE. Clinical and safety outcomes were compared between the two study groups (FPE vs non-FPE) using logistic regression models. Good outcome was defined as modified Rankin Scale 0–2 at 3 months.Results: Eight hundred thirty-six patients with a final mTICI ⩾ 2b were included in this analysis. FPE was observed in 302 patients (36.1%). In multivariable analysis, hypertension (aOR 1.55, 95% CI 1.10–2.20) and lower baseline NIHSS score (aOR 0.95, 95% CI 0.93–0.97) were independently associated with an FPE. Good outcomes were more common in the FPE versus non-FPE group (72.8% vs 52.8%), and FPE was independently associated with favorable outcome (aOR 2.20, 95% CI 1.59–3.05). 90-day mortality and intracranial hemorrhage (ICH) were significantly lower in the FPE group, 0.43 (95% CI, 0.25–0.72) and 0.55 (95% CI, 0.39–0.77), respectively.Conclusion: Over 2/3 of patients with MeVOs and FPE in our cohort had a favorable outcome at 90 days. FPE is independently associated with favorable outcomes, it may reduce the risk of any intracranial hemorrhage, and 3-month mortality.

Published
2024
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21. sj-docx-3-eso-10.1177_23969873231151262 – Supplemental material for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis

Author

Toh, Keith Zhi Xian, Koh, Ming Yi, Loh, Enver De Wei, Kwok, Gabriel Yi Ren, Teo, Yao Hao, Teo, Yao Neng, Goh, Claire Xin Yi, Syn, Nicholas Li Xun, Ho, Andrew Fu Wah, Sia, Ching-Hui, Brouwer, Patrick A, Andersson, Tommy, Meyer, Lukas, Fiehler, Jens, Bhogal, Pervinder, Sharma, Vijay K, Tan, Benjamin YQ, and Yeo, Leonard L L

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-docx-3-eso-10.1177_23969873231151262 for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis by Keith Zhi Xian Toh, Ming Yi Koh, Enver De Wei Loh, Gabriel Yi Ren Kwok, Yao Hao Teo, Yao Neng Teo, Claire Xin Yi Goh, Nicholas Li Xun Syn, Andrew Fu Wah Ho, Ching-Hui Sia, Patrick A Brouwer, Tommy Andersson, Lukas Meyer, Jens Fiehler, Pervinder Bhogal, Vijay K Sharma, Benjamin YQ Tan and Leonard L L Yeo in European Stroke Journal

Published
2023
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22. sj-docx-2-eso-10.1177_23969873231151262 – Supplemental material for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis

Author

Toh, Keith Zhi Xian, Koh, Ming Yi, Loh, Enver De Wei, Kwok, Gabriel Yi Ren, Teo, Yao Hao, Teo, Yao Neng, Goh, Claire Xin Yi, Syn, Nicholas Li Xun, Ho, Andrew Fu Wah, Sia, Ching-Hui, Brouwer, Patrick A, Andersson, Tommy, Meyer, Lukas, Fiehler, Jens, Bhogal, Pervinder, Sharma, Vijay K, Tan, Benjamin YQ, and Yeo, Leonard L L

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-docx-2-eso-10.1177_23969873231151262 for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis by Keith Zhi Xian Toh, Ming Yi Koh, Enver De Wei Loh, Gabriel Yi Ren Kwok, Yao Hao Teo, Yao Neng Teo, Claire Xin Yi Goh, Nicholas Li Xun Syn, Andrew Fu Wah Ho, Ching-Hui Sia, Patrick A Brouwer, Tommy Andersson, Lukas Meyer, Jens Fiehler, Pervinder Bhogal, Vijay K Sharma, Benjamin YQ Tan and Leonard L L Yeo in European Stroke Journal

Published
2023
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23. sj-docx-1-eso-10.1177_23969873231151262 – Supplemental material for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis

Author

Toh, Keith Zhi Xian, Koh, Ming Yi, Loh, Enver De Wei, Kwok, Gabriel Yi Ren, Teo, Yao Hao, Teo, Yao Neng, Goh, Claire Xin Yi, Syn, Nicholas Li Xun, Ho, Andrew Fu Wah, Sia, Ching-Hui, Brouwer, Patrick A, Andersson, Tommy, Meyer, Lukas, Fiehler, Jens, Bhogal, Pervinder, Sharma, Vijay K, Tan, Benjamin YQ, and Yeo, Leonard L L

Subjects
FOS: Clinical medicine, Cardiology, Medicine, 110904 Neurology and Neuromuscular Diseases
Abstract

Supplemental material, sj-docx-1-eso-10.1177_23969873231151262 for Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis by Keith Zhi Xian Toh, Ming Yi Koh, Enver De Wei Loh, Gabriel Yi Ren Kwok, Yao Hao Teo, Yao Neng Teo, Claire Xin Yi Goh, Nicholas Li Xun Syn, Andrew Fu Wah Ho, Ching-Hui Sia, Patrick A Brouwer, Tommy Andersson, Lukas Meyer, Jens Fiehler, Pervinder Bhogal, Vijay K Sharma, Benjamin YQ Tan and Leonard L L Yeo in European Stroke Journal

Published
2023
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24. Distal medium vessel occlusions in acute ischaemic stroke – Stent retriever versus direct aspiration: A systematic review and meta-analysis

Author

Toh, Keith Zhi Xian, primary, Koh, Ming Yi, additional, Loh, Enver De Wei, additional, Kwok, Gabriel Yi Ren, additional, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Goh, Claire Xin Yi, additional, Syn, Nicholas Li Xun, additional, Ho, Andrew Fu Wah, additional, Sia, Ching-Hui, additional, Brouwer, Patrick A, additional, Andersson, Tommy, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Bhogal, Pervinder, additional, Sharma, Vijay K, additional, Tan, Benjamin YQ, additional, and Yeo, Leonard L L, additional

Published
2023
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25. Impact of atrial fibrillation on the treatment effect of bridging thrombolysis in ischemic stroke patients undergoing endovascular thrombectomy: a multicenter international cohort study

Author

Loo, Jing Hong, primary, Leow, Aloysius ST, additional, Jing, Mingxue, additional, Sia, Ching-Hui, additional, Chan, Bernard PL, additional, Seet, Raymond CS, additional, Teoh, Hock-Luen, additional, Meyer, Lukas, additional, Fiehler, Jens, additional, Papanagiotou, Panagiotis, additional, Kastrup, Andreas, additional, Mpotsaris, Anastasios, additional, Maus, Volker, additional, Yapici, Furkan, additional, Simonato, Davide, additional, Gabrieli, Joseph D, additional, Cester, Giacomo, additional, Bhogal, Pervinder, additional, Spooner, Oliver, additional, Nikola, Christos, additional, Joshi, Abhishek, additional, Lee, Tsong-Hai, additional, Wu, Jiale, additional, Chen, Yimin, additional, Yang, Shuiquan, additional, Sharma, Vijay Kumar, additional, Tan, Benjamin YQ, additional, and Yeo, Leonard LL, additional

Published
2023
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26. Endovascular therapy for acute ischemic stroke with distal medium vessel occlusion: a systematic review and meta-analysis

Author

Loh, Enver De Wei, primary, Toh, Keith Zhi Xian, additional, Kwok, Gabriel Yi Ren, additional, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Goh, Claire, additional, Syn, Nicholas L, additional, Ho, Andrew Fu-Wah, additional, Sia, Ching-Hui, additional, Sharma, Vijay Kumar, additional, Tan, Benjamin YQ, additional, and Yeo, Leonard LL, additional

Published
2022
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28. Incidence of acute cerebrovascular events in patients with rheumatic or calcific mitral stenosis: A systematic review and meta-analysis

Author

Siah, Qi Zhuang, primary, Pang, Bao Yu, additional, Ye, Tiffany TS., additional, Ho, Jamie SY., additional, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Syn, Nicholas LX., additional, Tan, Benjamin YQ., additional, Wong, Raymond CC., additional, Yeo, Leonard LL., additional, Lee, Edward CY., additional, Li, Tony YW., additional, Poh, Kian-Keong, additional, Kong, William KF., additional, Yeo, Tiong-Cheng, additional, Chai, Ping, additional, and Sia, Ching-Hui, additional

Published
2022
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29. Investigating Psychological Differences Between Nurses and Other Health Care Workers From the Asia-Pacific Region During the Early Phase of COVID-19: Machine Learning Approach

Author

Dong, YanHong, primary, Yeo, Mei Chun, additional, Tham, Xiang Cong, additional, Danuaji, Rivan, additional, Nguyen, Thang H, additional, Sharma, Arvind K, additional, RN, Komalkumar, additional, PV, Meenakshi, additional, Tai, Mei-Ling Sharon, additional, Ahmad, Aftab, additional, Tan, Benjamin YQ, additional, Ho, Roger C, additional, Chua, Matthew Chin Heng, additional, and Sharma, Vijay K, additional

Published
2022
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30. 15 Ischaemic events in hypertrophic cardiomyopathy patients with and without atrial fibrillation: a systematic review and meta-analysis

Author

Siah, Qi Zhuang, primary, Ye, Tiffany TS, additional, Tan, Benjamin YQ, additional, Ho, Jamie SY, additional, Syn, Nicholas LX, additional, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Yip, James W, additional, Yeo, Tiong-Cheng, additional, Lin, Weiqin, additional, Wong, Raymond CC, additional, Chai, Ping, additional, Chan, Bernard, additional, Sharma, Vijay Kumar, additional, Yeo, Leonard LL, additional, and Sia, Ching-Hui, additional

Published
2022
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31. P2Y12 inhibitors for the neurointerventionalist

Author

Borchert, Robin J, Simonato, Davide, R Hickman, Charlotte, Fuschi, Maurizio, Thibault, Lucie, Henkes, Hans, Fiorella, David, Tan, Benjamin Yq, Yeo, Leonard Ll, D Makalanda, Hegoda L, Wong, Ken, Bhogal, Pervinder, Borchert, Robin J [0000-0002-4673-9746], Simonato, Davide [0000-0003-3601-9136], Yeo, Leonard Ll [0000-0002-4249-0402], Bhogal, Pervinder [0000-0002-5514-5237], and Apollo - University of Cambridge Repository

Subjects
thrombectomy, Endovascular Procedures, aneurysm, Humans, Stents, cardiovascular diseases, Antiplatelets, hemorrhage, stroke, Platelet Aggregation Inhibitors
Abstract

The use of antiplatelets is widespread in clinical practice. However, for neurointerventional procedures, protocols for antiplatelet use are scarce and practice varies between individuals and institutions. This is further complicated by the quantity of antiplatelet agents which differ in route of administration, dosage, onset of action, efficacy and ischemic and hemorrhagic complications. Clarifying the individual characteristics for each antiplatelet agent, and their associated risks, will increasingly become relevant as the practice of mechanical thrombectomy, stenting, coiling and flow diversion procedures grows. The aim of this review is to summarize the existing literature for the use of P2Y12 inhibitors in neurointerventional procedures, examine the quality of the evidence, and highlight areas in need of further research.

Published
2022

33. Benefit and risk of intravenous alteplase in patients with acute large vessel occlusion stroke and low ASPECTS

Author

Broocks, Gabriel, primary, McDonough, Rosalie, additional, Bechstein, Matthias, additional, Hanning, Uta, additional, Brekenfeld, Caspar, additional, Flottmann, Fabian, additional, Kniep, Helge, additional, Nawka, Marie Teresa, additional, Deb-Chatterji, Milani, additional, Thomalla, Götz, additional, Sporns, Peter, additional, Yeo, Leonard LL, additional, Tan, Benjamin YQ, additional, Gopinathan, Anil, additional, Kastrup, Andreas, additional, Politi, Maria, additional, Papanagiotou, Panagiotis, additional, Kemmling, Andre, additional, Fiehler, Jens, additional, and Meyer, Lukas, additional

Published
2022
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34. Effects of Sodium/Glucose Cotransporter 2 (SGLT2) Inhibitors on Cardiac Imaging Parameters: A Systematic Review and Meta-analysis of Randomized Controlled Trials

Author

Wee, Caitlin Fern, primary, Teo, Yao Hao, additional, Teo, Yao Neng, additional, Syn, Nicholas LX, additional, See, Ray Meng, additional, Leong, Shariel, additional, Yip, Alicia Swee Yan, additional, Ong, Zhi Xian, additional, Lee, Chi-Hang, additional, Chan, Mark Yan-Yee, additional, Poh, Kian-Keong, additional, Ong, Ching-Ching, additional, Teo, Lynette LS, additional, Singh, Devinder, additional, Tan, Benjamin YQ, additional, Yeo, Leonard LL, additional, Kong, William KF, additional, Yeo, Tiong-Cheng, additional, Wong, Raymond CC, additional, Chai, Ping, additional, and Sia, Ching-Hui, additional

Published
2022
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35. Associations of Metabolic-Bariatric Surgery with Long-Term Cardiovascular Events and Survival: A One-Stage Meta-Analysis

Author

Ho, Clare Si Min Elisabeth, primary, Tan, Sean, additional, Syn, Nicholas L., additional, Tan, Benjamin YQ, additional, Dalakoti, Mayank, additional, Wong, Raymond CC, additional, Yeo, Leonard LL, additional, Yip, James WL, additional, Lim, Amanda Yuan Ling, additional, Yeo, Tiong-Cheng, additional, Chai, Ping, additional, Cummings, David, additional, Shabbir, Asim, additional, Chan, Mark Y., additional, and Sia, Ching-Hui, additional

Published
2022
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36. Association of triglyceride-glucose index with clinical outcomes in patients with acute ischemic stroke receiving intravenous thrombolysis

Author

Toh, Emma MS, Lim, Amanda YL, Ming, Chua, Yeo, Leonard LL, Sia, Ching-Hui, Tan, Bryce WQ, Leow, Aloysius ST, Ho, Jamie SY, Chan, Bernard PL, Sharma, Vijay Kumar, Tan, Benjamin YQ, and Apollo - University of Cambridge Repository

Subjects
Stroke, Multidisciplinary, Cerebrovascular disorders, Science, Tissue Plasminogen Activator, Medicine, Endocrine system and metabolic diseases, Article
Abstract

Intravenous tissue plasminogen activator (tPA) remains the cornerstone of recanalization therapy for acute ischemic stroke (AIS), albeit with varying degrees of response. The triglyceride-glucose (TyG) index is a novel marker of insulin resistance, but association with outcomes among AIS patients who have received tPA has not been well elucidated. We studied 698 patients with AIS who received tPA from 2006 to 2018 in a comprehensive stroke centre. TyG index was calculated using the formula: ln[fasting triglycerides (mg/dL) × fasting glucose (mg/dL)/2]. TyG index was significantly lower in patients that survived at 90-days than those who died (8.61 [Interquartile Range: 8.27–8.99] vs 8.76 [interquartile range: 8.39–9.40], p = 0.007). In multivariate analysis, TyG index was significantly associated with 90-day mortality (OR: 2.12, 95% CI: 1.39–3.23, p = 0.001), poor functional outcome (OR: 1.41 95% CI: 1.05–1.90, p = 0.022), and negatively associated with early neurological improvement (ENI) (OR: 0.68, 95% CI: 0.52–0.89, p = 0.004). There was no association between TyG index and symptomatic intracranial hemorrhage. ‘High TyG’ (defined by TyG index ≥ 9.15) was associated with mortality, poor functional outcomes and no ENI. In conclusion, the TyG index, a measure of insulin resistance, was significantly associated with poorer clinical outcomes in AIS patients who received tPA.

Published
2021

37. Investigating Psychological Differences Between Nurses and Other Health Care Workers From the Asia-Pacific Region During the Early Phase of COVID-19: Machine Learning Approach (Preprint)

Author

Dong, YanHong, primary, Yeo, Mei Chun, additional, Tham, Xiang Cong, additional, Danuaji, Rivan, additional, Nguyen, Thang H, additional, Sharma, Arvind K, additional, RN, Komalkumar, additional, PV, Meenakshi, additional, Tai, Mei-Ling Sharon, additional, Ahmad, Aftab, additional, Tan, Benjamin YQ, additional, Ho, Roger C, additional, Chua, Matthew Chin Heng, additional, and Sharma, Vijay K, additional

Published
2021
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38. Incidence of acute cerebrovascular events in patients with rheumatic or calcific mitral stenosis: A systematic review and meta-analysis

Author

Siah, Qi Zhuang, Pang, Bao Yu, Ye, Tiffany TS., Ho, Jamie SY., Teo, Yao Hao, Teo, Yao Neng, Syn, Nicholas LX., Tan, Benjamin YQ., Wong, Raymond CC., Yeo, Leonard LL., Lee, Edward CY., Li, Tony YW., Poh, Kian-Keong, Kong, William KF., Yeo, Tiong-Cheng, Chai, Ping, and Sia, Ching-Hui

Abstract

Patients with mitral stenosis (MS) may be predisposed to acute cerebrovascular events (ACE) and peripheral thromboembolic events (TEE). Concomitant atrial fibrillation (AF), mitral annular calcification (MAC) and rheumatic heart disease (RHD) are independent risk factors. Our aim was to evaluate the incidence of ACEs in MS patients and the implications of AF, MAC and RHD on thromboembolic risks.

Published
2023
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39. Thrombectomy for secondary distal, medium vessel occlusions of the posterior circulation: seeking complete reperfusion

Author

Meyer, Lukas, primary, Stracke, Christian Paul, additional, Wallocha, Marta, additional, Broocks, Gabriel, additional, Sporns, Peter B, additional, Piechowiak, Eike I, additional, Kaesmacher, Johannes, additional, Maegerlein, Christian, additional, Dorn, Franziska, additional, Zimmermann, Hanna, additional, Naziri, Weis, additional, Abdullayev, Nuran, additional, Kabbasch, Christoph, additional, Behme, Daniel, additional, Jamous, Ala, additional, Maus, Volker, additional, Fischer, Sebastian, additional, Möhlenbruch, Markus, additional, Weyland, Charlotte Sabine, additional, Langner, Soenke, additional, Meila, Dan, additional, Miszczuk, Milena, additional, Siebert, Eberhard, additional, Lowens, Stephan, additional, Krause, Lars Udo, additional, Yeo, Leonard LL, additional, Tan, Benjamin YQ, additional, Gopinathan, Anil, additional, Gory, Benjamin, additional, Arenillas, Juan F, additional, Navia, Pedro, additional, Raz, Eytan, additional, Shapiro, Maksim, additional, Arnberg, Fabian, additional, Zeleňák, Kamil, additional, Martínez-Galdámez, Mario, additional, Kastrup, Andreas, additional, Papanagiotou, Panagiotis, additional, Kemmling, Andre, additional, Psychogios, Marios N, additional, Andersson, Tommy, additional, Chapot, René, additional, Fiehler, Jens, additional, and Hanning, Uta, additional

Published
2021
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40. P2Y12 inhibitors for the neurointerventionalist

Author

Borchert, Robin J, primary, Simonato, Davide, additional, R Hickman, Charlotte, additional, Fuschi, Maurizio, additional, Thibault, Lucie, additional, Henkes, Hans, additional, Fiorella, David, additional, Tan, Benjamin YQ, additional, Yeo, Leonard LL, additional, D Makalanda, Hegoda L, additional, Wong, Ken, additional, and Bhogal, Pervinder, additional

Published
2021
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41. Glycoprotein IIb/IIIa inhibitors for the neurointerventionalist

Author

Simonato, Davide, primary, Borchert, Robin J, additional, Labeyrie, Marc-Antoine, additional, Fuschi, Maurizio, additional, Thibault, Lucie, additional, Henkes, Hans, additional, Fiorella, David, additional, Tan, Benjamin YQ, additional, Yeo, Leonard LL, additional, Makalanda, Hegoda LD, additional, Wong, Ken, additional, and Bhogal, Pervinder, additional

Published
2021
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42. Abstract P607: Interplay Between Post-Myocardial Infarction Left Ventricular Systolic Dysfunction and Atrial Fibrillation: Prognostic Implications for Post-Myocardial Infarction Acute Ischaemic Stroke

Author

Sia, Ching Hui, primary, Tan, Benjamin YQ, additional, Zheng, Huili, additional, Ho, Andrew, additional, Foo, David, additional, Foo, Ling-Li, additional, Lim, Patrick Zhan-Yun, additional, Liew, Boon Wah, additional, Ahmad, Aftab, additional, Chan, Bernard P, additional, Chang, Hui Meng, additional, Kong, Keng He, additional, Young, Sherry, additional, Tang, Kok Foo, additional, Chua, Terrance, additional, Hausenloy, Derek J, additional, Tiong-Cheng, Yeo, additional, Tan, Huay Cheem, additional, Venketasubramanian, Narayanaswamy, additional, Yeo, Leonard, additional, and Chan, Mark Y, additional

Published
2021
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44. Benefit and risk of intravenous alteplase in patients with acute large vessel occlusion stroke and low ASPECTS

Author

Broocks, Gabriel, McDonough, Rosalie, Bechstein, Matthias, Hanning, Uta, Brekenfeld, Caspar, Flottmann, Fabian, Kniep, Helge, Nawka, Marie Teresa, Deb-Chatterji, Milani, Thomalla, Go¨tz, Sporns, Peter, Yeo, Leonard LL, Tan, Benjamin YQ, Gopinathan, Anil, Kastrup, Andreas, Politi, Maria, Papanagiotou, Panagiotis, Kemmling, Andre, Fiehler, Jens, and Meyer, Lukas

Abstract

BackgroundThe benefit of best medical treatment including intravenous alteplase (IVT) before mechanical thrombectomy (MT) in patients with acute ischemic stroke and extensive early ischemic changes on baseline CT remains uncertain. The purpose of this study was to evaluate the benefit of IVT for patients with low ASPECTS (Alberta Stroke Programme Early CT Score) compared with patients with or without MT.MethodsThis multicenter study pooled consecutive patients with anterior circulation acute stroke and ASPECTS≤5 to analyze the impact of IVT on functional outcome, and to compare bridging IVT with direct MT. Functional endpoints were the rates of good (modified Rankin Scale (mRS) score ≤2) and very poor (mRS ≥5) outcome at day 90. Safety endpoint was the occurrence of symptomatic intracranial hemorrhage (sICH).Results429 patients were included. 290 (68%) received IVT and 168 (39%) underwent MT. The rate of good functional outcome was 14.4% (95% CI 7.1% to 21.8%) for patients who received bridging IVT and 24.4% (95% CI 16.5% to 32.2%) for those who underwent direct MT. The rate of sICH was significantly higher in patients with bridging IVT compared with direct MT (17.8% vs 6.4%, p=0.004). In multivariable logistic regression analysis, IVT was significantly associated with very poor outcome (OR 2.22, 95% CI 1.05 to 4.73, p=0.04) and sICH (OR 3.44, 95% CI 1.18 to 10.07, p=0.02). Successful recanalization, age, and ASPECTS were associated with good functional outcome.ConclusionsBridging IVT in patients with low ASPECTS was associated with very poor functional outcome and an increased risk of sICH. The benefit of this treatment should therefore be carefully weighed in such scenarios. Further randomized controlled trials are required to validate our findings.

Published
2023
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45. Endovascular therapy for acute ischemic stroke with distal medium vessel occlusion: a systematic review and meta-analysis

Author

Loh, Enver De Wei, Toh, Keith Zhi Xian, Kwok, Gabriel Yi Ren, Teo, Yao Hao, Teo, Yao Neng, Goh, Claire, Syn, Nicholas L, Ho, Andrew Fu-Wah, Sia, Ching-Hui, Sharma, Vijay Kumar, Tan, Benjamin YQ, and Yeo, Leonard LL

Abstract

AimsEndovascular therapy (EVT) for distal medium vessel occlusions (DMVOs) is a potential frontier of acute ischemic stroke (AIS) treatment, but its efficacy against best medical therapy (BMT) remains unknown. We performed a systematic review and meta-analysis evaluating the efficacy and safety of EVT versus BMT in primary DMVO.MethodsWe systematically searched PubMed, Cochrane Library and Embase, from inception to August 14, 2022, for studies comparing EVT with BMT in DMVO-AIS. We adopted the Distal Thrombectomy Summit Group’s definition of DMVO. Efficacy outcomes were functional independence (90-day modified Rankin Scale (mRS) 0–2) and excellent functional outcomes (90-day mRS 0–1). Safety outcomes were symptomatic intracranial hemorrhage (sICH) and 90-day mortality.ResultsFourteen observational and two randomized-controlled studies were included, with 1202 patients receiving EVT and 1267 receiving BMT. After trim-and-fill correction, EVT achieved significantly better odds of functional independence than BMT (adjusted OR 1.61, 95% CI 1.06 to 2.43). There were no significant differences in overall excellent functional outcomes (OR 1.23, 95% CI 0.88 to 1.71), sICH (OR 1.44, 95% CI 0.78 to 2.66), and mortality (OR 1.03, 95% CI 0.73 to 1.45). Stratified by EVT method, mechanical thrombectomy±intra-arterial thrombolysis achieved more excellent functional outcomes than BMT (OR 1.59, 95% CI 1.13 to 2.23). In mild strokes (National Institutes of Health Stroke Scale score <6), EVT caused significantly more sICH (OR 6.30, 95% CI 1.55 to 25.64).ConclusionsEVT shows promising efficacy benefit over BMT for primary DMVO-AIS. Further randomized controlled trials are necessary to evaluate the efficacy and safety of EVT in DMVO-AIS.

Published
2023
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46. Acute Coronavirus Disease (COVID-19) in Vaccinated Frontline Healthcare Workers in India: An Observational Cohort Study

Author

Ngiam, Jinghao Nicholas, primary, Tan, Benjamin YQ, additional, Khan, Erum, additional, Chew, Nicholas WS, additional, PMS, Suryanarayana Sharma, additional, Batra, Amit, additional, Kulkarni, Amit, additional, RN, Komalkumar, additional, PV, Meenaakshi, additional, Chan, Amanda CY, additional, Ong, Jonathan JY, additional, Yeo, Leonard LL, additional, Talati, Kalpesh, additional, Sharma, Arvind K., additional, and Sharma, Vijay K., additional

Published
2021
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47. Determinants of Burnout and Other Aspects of Psychological Well-Being in Healthcare Workers During the COVID-19 Pandemic: A Multinational Cross-Sectional Study

Author

Scott, Alasdair, primary, Tan, Benjamin YQ, additional, Huak, Chan Yiong, additional, Sia, Ching-Hui, additional, Xian, Chua Ying, additional, Goh, Ee Teng, additional, Zbikowska, Gabriela, additional, Dykowska, Grazyna, additional, Martin, Guy, additional, Kinross, James, additional, Przybylowicz, Jan, additional, Fedorowski, Jaroslaw, additional, Beatty, Jasmine Winter, additional, Clarke, Jonathan, additional, Sim, Kang, additional, Abhiram, Kanneganti, additional, Flott, Kelsey, additional, Lim, Lucas JH, additional, Wells, Mary, additional, Denning, Max, additional, Almonte, Melanie T, additional, Tan, Melanie, additional, Mason, Sam, additional, Purkayastha, Sanjay, additional, Yalamanchili, Seema, additional, Markar, Sheraz, additional, Ooi, Shirley BS, additional, Chidambaran, Swathikan, additional, Lifeng, Tan, additional, Sharma, Vijay K, additional, and Sounderajah, Viknesh, additional

Published
2020
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48. Nation-Wide Observational Study of Cardiac Arrests Occurring in Nursing Homes and Nursing Facilities in Singapore

Author

Ho, Andrew FW, primary, Lee, Kai Yi, additional, Lin, Xinyi, additional, Hao, Ying, additional, Shahidah, Nur, additional, Ng, Yih Yng, additional, Leong, Benjamin SH, additional, Sia, Ching-Hui, additional, Tan, Benjamin YQ, additional, Tay, Ai Meng, additional, Ng, Marie XR, additional, Gan, Han Nee, additional, Mao, Desmond R, additional, Chia, Michael YC, additional, Cheah, Si Oon, additional, and Ong, Marcus EH, additional

Published
2020
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49. Significant aortic stenosis associated with poorer functional outcomes in patients with acute ischaemic stroke undergoing endovascular therapy

Author

Ngiam, Nicholas JH, primary, Tan, Benjamin YQ, additional, Sia, Ching-Hui, additional, Chan, Bernard PL, additional, Anil, Gopinathan, additional, Cunli, Yang, additional, Holmin, Staffan, additional, Anderssen, Tommy, additional, Poh, Kian-Keong, additional, Yeo, Leonard LL, additional, and Sharma, Vijay K, additional

Published
2020
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50. Glycoprotein IIb/IIIa inhibitors for the neurointerventionalist.

Author

Simonato, Davide, Borchert, Robin J, Labeyrie, Marc-Antoine, Fuschi, Maurizio, Thibault, Lucie, Henkes, Hans, Fiorella, David, Tan, Benjamin YQ, Yeo, Leonard LL, Makalanda, Hegoda LD, Wong, Ken, and Bhogal, Pervinder

Subjects
PLATELET aggregation inhibitors, CLINICAL trials, DRUGS
Abstract

Antiplatelet therapies are commonly used in neurointerventional procedures. However, specific guidelines for their use in these settings is lacking and it can often be difficult to balance the potential risks and benefits of these medications. Considering the continued growth and adoption of neurointerventional procedures, it is crucial to understand the properties of these agents in order to use them safely. Large-scale clinical trials are still needed to clarify many of these aspects for this emerging field. However, the existing literature already provides insight into which antiplatelet drugs are of benefit to the neurointerventionalist as well as their associated risks of ischemic and hemorrhagic complications. Hence, this review focuses on the applications of GPIIb/IIIA inhibitors to neurointerventional procedures. [ABSTRACT FROM AUTHOR]

Published
2022
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